SURGICAL INCISION AND CLOSURE APPARATUS

• US 20170143341A1
• Filed: 12/05/2016
• Published: 05/25/2017
• Est. Priority Date: 11/01/2011
• Status: Active Grant

• Current Assignee: Zipline Medical, Inc. (Stryker Corporation)
• Original Assignee: Zipline Medical, Inc. (Stryker Corporation)
• Inventors: Schaer, Alan, Rathi, Pankaj, Ichiryu, Keiichiro, D'Aquanni, Peter, Clauson, Luke, Belson, Amir, Storne, Eric, Feezor, Chris
• Granted Patent: US 10,456,136 B2
• Time in Patent Office: Days
• CPC Class Codes: A61B 17/00491 Surgical glue applicators surgical adhesives A61L24/00; two-component delivery syringes A61M5/19
• CPC Class Codes: A61B 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• CPC Class Codes: A61B 17/0466 Suture bridges
• CPC Class Codes: A61B 17/083 Clips, e.g. resilient
• CPC Class Codes: A61B 17/085 with adhesive layer
• CPC Class Codes: A61B 2017/00407 Ratchet means
• CPC Class Codes: A61B 2017/00747 Dermatology
• CPC Class Codes: A61B 2017/00862 elastic or resilient for sutures A61B2017/0618
• CPC Class Codes: A61B 2017/00884 enhancing wound closure
• CPC Class Codes: A61B 2017/00889 antimicrobial, disinfectant
• CPC Class Codes: A61B 2017/00907 for light
• CPC Class Codes: A61B 2017/00942 hydrophilic
• CPC Class Codes: A61B 2017/00951 adhesive
• CPC Class Codes: A61B 2017/00955 thermoplastic
• CPC Class Codes: A61B 2017/081 Tissue approximator A61B2017/1103, A61B17/8866 take precedence
• CPC Class Codes: A61B 2017/086 having flexible threads, filaments, laces or wires, e.g. parallel threads, extending laterally from a strip, e.g. for tying to opposing threads extending from a similar strip
• CPC Class Codes: A61B 2017/088 Sliding fasteners

Abstract

An apparatus for closing a surgical incision comprises left and right base panels, a plurality of closure components, and a plurality of left and right axial supports coupled to the respective base panels. The closure components couple the left and right base panels to each other laterally and have left and right ends coupled to the respective base panels. The closure components are positioned laterally across the left and right panels, the left axial supports are disposed between pairs of left closure component ends, the right axial supports are disposed between pairs of right closure component ends, and the left and right axial supports are offset from one another such that a serpentine arrangement of consecutive closure components and axial supports is formed. The apparatus can be made of antimicrobial materials or materials impregnated with antimicrobial agents. A flexible adhesive cover can be provided over the apparatus when in use.

Claims

1. A method of closing a wound or incision, the method comprising:

adhering first and second base panels to first and second sides of an incision or wound, respectively, each base panel comprising an upper surface, a tissue adherent lower surface, an outer lateral edge, and an inner lateral edge placed adjacent the incision or wound;

coupling the first and second base panels together with a plurality of lateral ties; and

applying a tissue glue to the incision or wound between the inner lateral edges of the first and second panels.

2. The method of claim 1, further comprising:

adhering at least one skirt to skin lateral of one or more of the outer lateral edge of the first base panel or the outer lateral edge of the second base panels,

wherein the at least one skirt is coupled to one or more of the first base panel upper surface or the second base panel upper surface, and

wherein the at least one skirt has greater compliance than a composite structure of the first and second base panels and the plurality of lateral ties, thereby providing strain relief between exposed skin lateral of the at least one skirt and one or more of the first base panel or second base panel as well as between skin covered by the first and second base panels and the tissue adherent lower surfaces of the first and second base panels, and

wherein adhering the at least one skirt comprises adhering a first skirt to skin lateral of the outer lateral edge of the first base panel and adhering a second skirt to skin lateral of the outer lateral edge of the second base panel, wherein the first skirt extends laterally from the outer lateral edge of the first base panel, and wherein the second skirt extends laterally from the outer lateral edge of the second base panel.

3. The method of claim 2, wherein adhering the at least one skirt comprises leaving the incision or wound uncovered by the at least one skirt.

4. The method of claim 2, wherein adhering the at least one skirt comprises extending the at least one skirt laterally inwardly to cover the incision or wound.

5. The method of claim 2, wherein an assembly of the lateral ties and the upper surfaces of the first and second base panels is less elastic than the lower adherent surfaces of the first and second base panels so that tissue is securely closed and the incision or wound is minimally disrupted by movement.

6. The method of claim 2, wherein the adherent lower surface of the first and second base panels is more elastic than at least the upper surface of the first and second base panels and the plurality of lateral ties so that movement of underlying skin and tissue is followed and adhesion is maintained.

20. The method of claim 1, further comprising longitudinally stretching one or more of the adhered first and second base panels to separate the one or more of the first and second base panels into a plurality of discrete and separate base panel segments.

21. The method of claim 20, wherein the one or more of the first and second base panels comprise a plurality of preferentially separating regions distributed along a length thereof the facilitate the separation.

22. The method of claim 21, wherein the plurality of preferentially separating regions comprise a plurality of perforations.

23. The method of claim 1, wherein the lateral ties each have a first end permanently fixed to a support on the first base panel and a second end opposite the first end, and wherein coupling the first and second base panels together with the plurality of lateral ties comprises reversibly and adjustably attaching the second end to the second base panel.

24. The method of claim 23, further comprising disengaging and re-engaging the first end of an individual lateral tie from the second base panel.

25. The method of claim 23, wherein reversibly and adjustably attaching the first end to the opposite base panel comprises releasably attaching the first end to a lock of the second base panel.

26. The method of claim 25, wherein the lateral tie and the lock together form a ratchet tightening mechanism.

27. The method of claim 23, further comprising independently adjusting the attachment of the first ends of the lateral ties to vary a spacing between the first and second base panels along lengths thereof.

30. The method of claim 1, further comprising placing first and second sacrificial covers over the first and second base panels, respectively, wherein the sacrificial covers each have an adherent lower surface and an upper surface.

31. The method of claim 30, further comprising placing a film over the first and second sacrificial covers, wherein a first separation force necessary to separate the first and second sacrificial covers from the first and second base panels, respectively, is configured to be less than a second separation force necessary to separate the first and second sacrificial covers from the film.

33. The method of claim 31 further comprising removing the film and the sacrificial covers from the first and second base panels while leaving the first and second base panels adhered to skin.

34. The method of claim 1, wherein the tissue glue comprises one or more of a cyanoacrylate adhesive, a cyanoacrylate, fibrin, albumin, or a glutaraldehyde based adhesive.

35. The method of claim 1, wherein the tissue glue is applied with an applicator device.

36. The method of claim 1, wherein the tissue glue is applied after the first and second base panels are coupled together.

7-19. -19. (canceled)

28. (canceled)

29. (canceled)

32. (canceled)